It takes quite a bit to entice an established CIO to pick up and move across the country. For Andy Crowder, it came in the opportunity to join Atrium Health, an organization that’s growing at a rapid, but deliberate pace, and establishing itself as a leader in innovation. In fact, due to its size and scale — particularly after merging with Wake Forest School of Medicine — Atrium has become “a living laboratory” where researchers can test ideas, and clinicians apply them in practice.
Recently, healthsystemCIO spoke with Crowder about his objectives at Atrium, the difficult balance leaders face in maintaining systems while also fostering innovation, and what has surprised him most about the 42-hospital system. He also talks about the groundbreaking work clinicians have done during the pandemic, the skillsets needed in today’s “new office,” and how he’s adjusting to life in the Tar Heel state.
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- “It’s a difficult balance to leverage your enterprise system, stay within the purview of your contract and your governance structures, and then still innovate.”
- Through the pandemic, one of Atrium Health’s most significant achievements has been in the ability to utilize predictive analytics and machine learning to address health disparities among African American and Hispanic patients.
- For a number of clinicians and our informatics leaders, developing solutions and rolling them out so quickly during the pandemic has been “some of the most meaningful work of their careers.”
- As teams move to remote work, it’s critical for leaders to find ways to facilitate interactions and ensure team members can find ways to connect.
- The most surprising thing to Crowder about Atrium Health has been the ability to execute on strategies quickly, despite its size.
Q&A with Andy Crowder, Part 2 [Click here to view Part 1]
Gamble: You mentioned Dr. Rasu Shrestha [Chief Strategy and Transformation Officer] — I’m sure it’s interesting working with him. Can you talk about the dynamic between the chief information officer and someone in that role?
Crowder: It’s interesting. There’s a careful balance between not chasing all of the shiny things. Innovation done right is about choosing the right problems of consequences, or future states, or the true North that you want to go after. Rasu also brought in Todd Dunn, who was Director of Innovation at Intermountain Health. He’s been a great addition to the team.
Transformation doesn’t happen without stress, difficulties or necessary tension. But when we leverage those resources from an innovation and a partnership point of view, we can truly get to a more significant outcome. Is this a vendor, or is this a partner we’re going to go do something with? We’re going to leverage a solution, we’re going to innovate, and we’re going to make investments in that space.
The burden is you end up looking at a hundred things to pick the two or three that you’re going to do in a year. That pace can be difficult. But at the end of the year, you look back and you see that without this alignment, you’d never have the opportunity to capitalize on it. It’s a difficult balance to leverage your enterprise standards, stay within the purview of your contract and your governance structures, and still do innovation. I don’t know that anybody’s figured it out perfectly, but we’re giving it one hell of a shot.
Gamble: One of other things I want to talk about is your role as chief information and analytics officer. How has it been different from other CIO roles you’ve held?
Crowder: What’s interesting for me is, it’s deliberate in the title. Craig Richardville, who was here before me, did some phenomenal work. And I think for him and for the other leaders, the callout is that it’s not just about transactional systems, it’s about knowledge and information and doing something significant with the data.
Actually, the role that I have here is not much different than the role I had at Scripps Health — in fact, the similarities are eerie. And that goes for MaineHealth and Florida Hospital too. I think the title difference is an obligation for us to do something different than just being in the report writing business; we need to be focused on deep insights and solutions and working across the organization in a much broader way. There’s an accountability, and it’s referenced in the title. It’s not good enough for me to just keep the transactional systems working or give these new digital capabilities if we don’t make better decisions and have better insights.
One of the really key important governance structures is our data and analytics steering committee, which sets the priority and strategy for the broader Atrium Health organization. Dr. Shrestha co-chairs that along with our legal counsel. Some may think that’s a bit odd, but if you think about how you’re going to leverage data differently across the enterprise, there are different types of relationships you need to have with your partners and your providers.
Gamble: It seems that really gets into the meat of all this, which is enabled physicians and clinicians to be able to use this data in different ways.
Crowder: Yes. I was so proud of Atrium Health during Covid. Drs. Andy McWilliams, Yhenneko Taylor, Philip Turk and the rest of the CORE [Center for Outcomes Research and Evaluation] team used predictive analytics to forecast what our infection rate would be, what the spread would look like, and the impact on beds. There’s no perfect model, but it was our data — not somebody else’s data — and so we were able to marry that rich clinical data we had in addition to what we were getting from a testing perspective. And that gave us the capability to actually do something that had not been done in the Charlotte market prior to COVID in the areas of health disparities among African-American and Hispanic patients. Due to that hot-spotting capability and the insights we had, we were able to intervene and close that gap from a disparities point of view, and achieve significant outcomes that were very different than other places.
That’s just one example, but it really did push IS, predictive analytics, machine learning, and AI to the forefront. [Atrium Health President and CEO] Gene Wood likes to talk about bright spots; this was a bright spot for our organization. Our data scientists and teams were at the table with Gene and others advising the county, the state and others on exactly what needed to be done. It was very fast paced. There was no doubt where IS had come from and where they were at now in this digital arena that we’re in.
Gamble: That’s powerful. As we know, it’s not always clear as to the impact IT can have.
Crowder: It was. At the beginning of almost all of our meetings, we do a ‘connect to purpose.’ We have so many rich examples. Our clinicians and our informatics leaders who were ad hoc designing technologies and solutions, and rolling them out in 24 to 48 hours, they look at those times and those events as the most meaningful work of their entire careers. And these are people that have been at this for 30-plus years. That’s a pretty profound statement.
Through our leaders like Maureen Swick [System Nurse Executive] and Becky Fox [CNIO] we’ve emphasized that human touch and connection are so important. During the early days of COVID, people couldn’t come to the hospital to see their and families and loved ones. People at the end of their life would have been isolated from their family, and so we used things like tablets and baby monitors.
There were some incredible stories that came out of that. Becky [Fox] and the clinical team launched a connection nurse program in which nurses who weren’t able to physically care for patients leveraged technology from our virtual solutions to connect patients with their loved ones, and make sure they could traverse the technology.
When you hear family members praying with one another and celebrating birthdays, and you see the expression on their face change immediately when they get that connection restored, it’s powerful. There was a story of a couple in their late eighties who hadn’t gone a day without seeing each other for almost 40 years, but due to some of the logistics, they couldn’t be in the same room. Something as simple as a $200 baby monitor was able to help lower their anxiety and improve their care. The ability to touch peoples’ lives during this time has been significant.
Gamble: One of the other areas I wanted to touch on is behavioral health. It seems like there’s a big opportunity to leverage telehealth to reach more patients.
Crowder: Yes. And Actually, Martha Whitecotton [Senior VP for Behavior Health] was recognized as a national leader in her work with behavioral health. We’ve had a virtual behavioral health program at Atrium Health for a long time, and an assessment protocol. When a primary care doctor or otherwise sees indicators, they’re able to virtually connect with a behavioral health specialist to help intervene.
And it’s not just about physical care. It is about caring for the whole person, and that was significant during the early days of Covid. I think it’s going to be one of the most significant things that we have to focus on the longer this pandemic goes on.
Gamble: I want to talk about leadership and how it has changed with so many people moving to remote work. What are you doing to make sure your team is getting when they need?
Crowder: I can speak to the experience that I’ve had with my direct teammates and the stories that have been shared with other leaders. We very aggressively moved a large body of individuals remote. Fortunately we had laid the foundation with Teams and many other collaborative technologies. We had a rollout schedule when we were originally planning to make the transition to Teams; but when we went remote, it was accelerated significantly.
We’ve sent out surveys to the employees who transitioned to remote to help prioritize the areas where they needed help, either with technology, equipment, or wanting to leverage the tools differently. We learned that they needed support in managing virtual teams, and so our HR education partners created content very quickly to scale up. We’ve done webinars, virtual happy hours, holiday celebrations, things like that. I think it’s important to go on camera as much as you can, and find ways to connect the teammates were conversations can occur organically.
What’s interesting is the meetings that used to take an hour now take 22 minutes, but they don’t factor in that 8 to 10 minutes of transition time. Some of the new tools actually break it down. With Teams and Microsoft 365, there’s a tracker that lets you know, how you’re doing and where you’re spending your time. And we get updates that say, ‘You know, you haven’t had any transition time. You might want to slow down.’ So we’ve put in some guardrails and some guidance to teammates on how they can not just survive, but thrive in that space.
Gamble: Right. So you knew coming into this role that there was a lot that needed to be done. Of course, nobody could have predicted the pandemic, but overall, do you feel you made the right move?
Crowder: Absolutely. I’ve been fortunate to be with some phenomenal organizations. I’ve had such a great experiential learning journey — every one of those organizations helped prepared me for this opportunity really well.
Our executive leaders have said, ‘I can’t believe you’ve only been here a year. It feels like you’ve been part of the team for a long time.’ What’s interesting is that Gene Woods and many of the other senior leaders are somewhat new to these roles. And so we’ve got a real energy and a passion for the future.
What I’ve noticed about Atrium — and some would find it hard to believe — is that it’s been easier to move and accelerate items here than at any other organization. I’ve been at some wonderful organizations, but the speed to execution and the trust and collaboration of the leadership team is second to none. Gene says he would put this team up against any other team in the nation, and I’d agree with him. He’s done a phenomenal job of picking his talent.
Gamble: Right. Is there anything that has surprised your about the role or about the organization?
Crowder: Not really. What’s interesting is the interview process was very, very robust — on both sides. Both parties had the opportunity to have the second and third iteration of conversations and questions. I think the recruiting firm did a phenomenal job of sizing it up. And so I haven’t really been surprised.
The only thing that was surprising to me was how quickly and easily the digital acceleration strategy came together. It happened in less than four months. Our governance process redesigned the integration with our groups, and they were able to quickly make decisions. You’d have thought that with a large organization, the bureaucracy and processes would be more difficult. It was not at all. That was the biggest surprise; that we would take forward a strategy, align our stakeholders, and execute that quickly. That was the most surprising part for me. I expected it to be more cumbersome and it wasn’t at all.